How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $102.33 | Professional | None | $100.00 | $100.00 | $102.33 |
BCBS South Carolina Setting Professional Modifier None Typical Low $107.15 Median $117.49 Typical High $147.91 | Professional | None | $107.15 | $117.49 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $223.87 Typical High $309.03 | Facility | None | $144.54 | $223.87 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Medcost Setting Facility Modifier None Typical Low $100.00 Median $120.23 Typical High $134.90 | Facility | None | $100.00 | $120.23 | $134.90 |
Medcost Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $162.18 | Professional | None | $114.82 | $114.82 | $162.18 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $87.10 | Professional | None | $83.18 | $83.18 | $87.10 |
United Setting Professional Modifier None Typical Low $107.15 Median $125.89 Typical High $125.89 | Professional | None | $107.15 | $125.89 | $125.89 |
9 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $50.12 Typical High $51.29 | Professional | 52 · Reduced service | $50.12 | $50.12 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $19.95 Typical High $20.42 | Professional | 53 · Discontinued | $19.95 | $19.95 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $15.49 | Professional | 55 · Aftercare only | $14.79 | $14.79 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.00 Typical High $10.23 | Professional | 56 · Pre-op care only | $10.00 | $10.00 | $10.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $57.54 Median $57.54 Typical High $123.03 | Professional | 51 · Multiple procedures | $57.54 | $57.54 | $123.03 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $22.91 Median $22.91 Typical High $48.98 | Professional | 80 · Assistant surgeon | $22.91 | $22.91 | $48.98 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $16.22 Median $16.22 Typical High $33.88 | Professional | 81 · Minimal assistant surgeon | $16.22 | $16.22 | $33.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $16.22 Median $16.22 Typical High $33.88 | Professional | 82 · Assistant surgeon, no resident | $16.22 | $16.22 | $33.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $16.22 Median $16.22 Typical High $33.88 | Professional | AS · PA/NP assist | $16.22 | $16.22 | $33.88 |
Where South Carolina sits
The same service costs 1.9 times more in North Dakota than in Hawaii. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
South Carolina· 38th of 51
$117
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.